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Stéphanie Badiou, Hélène Bellet, Sylvain Lehmann, Jean-Paul Cristol, Samir Jaber

Elevated plasma cysteinylglycine levels caused by cilastatin-associated antibiotic treatment

Keywords: aminothiols, cilastatin, cysteine, cysteinylglycine, glutathione, imipenem

Imipenem (thienamycin formamidine), a broad-spectrum ?-lactam antibiotic, is always used in combination with cilastatin in order to avoid the premature breakdown of imipenem by renal tubular dipeptidase. As this dipeptidase also hydrolyzes the glutathione metabolite cysteinylglycine, the therapeutic asso-ciation of imipenem and cilastatin might cause an accumulation of the aminothiol cysteinylglycine. We demonstrate here that when patients are treated with imipenem-cilastatin, their plasma levels of cysteinylglycine are significantly and specifically increased, while cysteine levels are decreased and homocysteine levels are unaffected. We conclude that antibiotic treatment using imipenem-cilastatin induces important metabolic changes that should not remain unrecognized.

Clinical Chemical Laboratory Medicine, Walter de Gruyter

Print ISSN: 1434-6621
Volume: 43, 03/2005
Pages: 332 - 334

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